Resident Semi Annual Evaluation Maine-Dartmouth Family Medicine Residency Program
Resident: Advisor: Date of Review:
Subjective/ Individualized Education Plan: contextual information about resident (i.e. where they came from, where they are emotionally/socially, etc.) and background information on her/ his goals and plans
Objective: data from portfolio/ folder (evaluation tools available and results), from conversations with advisor, preceptors, other faculty and peers
Curriculum Requirements: Required supplemental study completed? y/n Other numbers (attach Summary Sheet): · On target: · Concern: Competencies: 1) Patient Care: · Rotation Evaluations (3=meets expectations): · Chart audits: · Pace (pts/hr): · Sign Out · Observations: · Precepting Feedback:
2) Medical Knowledge:
· Rotation Evaluations (3=meets expectations): · Specific topics not being met:
· In-training exam scores:
Novice (identifies/uses rules of thumb): Follows specific rules for specific circumstances regardless of modifers or context. No personal ownership/responsibility except to the rule (i.e., EKG for chest pain no if's, and's or but's). Advanced Beginner (connects rules to reality): Decisions made by rule application but some allowance for related conditions. No personal ownership/responsibility (i.e., EKG for dyspnea since that might be cardiac). Competent (plans approach/execution and appreciates consequences): Applies organizing principles or "perspectives" instead of using rules based protocols. These perspectives allow for sorting information by relevance (triage). Has personal responsibility/ownership. (e.g., pt with CP may have modifying factors make EKG not necessary). Proficient (uses evidence and streamlines routines): "Holistic similarity recognition:" Intuitive assessment, uses decision-making tactics and rules to make plan. (i.e., "this is an MI, what are the criteria for TPA?"). Expert (anticipates and uses intuition): Does what works based on whole pattern recognition for both assessment and plan. No conscious breakdown into discrete elements. When this does not work, breaks down problem into discrete elements of rules and decision trees. 2) Target attending level behaviors (Dreyfus proficient): 1.Medical Knowledge: ¶Knows and applies the foundations of basic science and clinical and behavioral medicine appropriate to family practice. ¶Demonstrates through an analytical approach to clinical situations, an understanding and application of clinical medicine to patient care. 2.Patient Care: ¶Incorporates management of multiple interacting morbidities, prevention, up to date standard of care, prevention and controversy, and facilitates longitudinal care within the medical home. 3.Professionalism: ¶Demonstrates aware of ethical “gray zones” and variations in culture; can facilitate patient’s moral development in issues of cultural diversity through modeling and education 4.Interpersonal & Communication Skills: ¶Uses a variety of communication styles to facilitate patient understanding and behavior change ¶Manages family conflict, disruptive behavior, potentially litigious situations ¶Adjusts case presentation style and content based on patient complexity and context of the presentation ¶Ensures communication with PCP and that longitudinal chart incorporates all aspects of care 5.Practice-Based Learning and Improvement: ¶Uses the EMR and IT to educate patients and evaluate and enhance the quality of medical care ¶Shows facility with EMR and uses IT to access medical information regarding management of patients ¶Recognizes errors in patient care, analyzes own behavior, incorporates feedback and applies improvements to related situations on the future ¶Is able to provide effective and thoughtful feedback to peers ¶Is able to provide effective and thoughtful feedback to “superiors” 6.Systems-Based Practice: ¶Partners with health care managers and providers to assess, coordinate and improve health care, and knows how these activities affect system performance ¶Strives to affect public health and policy Works to create public health policy 7.Osteopathic Philosophy (for M.D.s AND D.O.s: ¶Understands a variety of modalities for whole person care and consistently applies those and/or refers appropriately 8.Osteopathic Manipulative Medicine (for D.O.s only): ¶Uses understanding of viscerosomatic reflexes and findings on structural exam to facilitate diagnosis & management of patients ¶Actively incorporates a variety of both direct and indirect techniques to address needs in a variety of encounter types
Plan with Advancement Committee: FED (feedback, encouragement and direction) including successful methods and techniques unique to this resident (verbal, written, demonstration, self-directed):
Maine-Dartmouth Family Medicine Residency Program
Resident: Advisor: Date of Review:
Subjective/ Individualized Education Plan: contextual information about resident (i.e. where they came from, where they are emotionally/socially, etc.) and background information on her/ his goals and plans
Objective: data from portfolio/ folder (evaluation tools available and results), from conversations with advisor, preceptors, other faculty and peers
Curriculum Requirements:
Required supplemental study completed? y/n
Other numbers (attach Summary Sheet):
· On target:
· Concern:
Competencies:
1) Patient Care:
· Rotation Evaluations (3=meets expectations):
· Chart audits:
· Pace (pts/hr):
· Sign Out
· Observations:
· Precepting Feedback:
2) Medical Knowledge:
· Rotation Evaluations (3=meets expectations):
· Specific topics not being met:
· In-training exam scores:
3) Practice-based Learning and Improvement:
· Rotation Evaluations (3=meets expectations):
· EMR skills:
4) Interpersonal and Communication Skills:
· Rotation Evaluations (3=meets expectations):
· 360s:
· Observations:
· Videotaped Sessions:
· Standardized Patients:
5) Professionalism:
· Rotation Evaluations (3=meets expectations):
· Individualized Education Plan (IEP):
6) Systems-based Practice:
· Rotation Evaluations (3=meets expectations):
Assessment:
1) Dreyfus level Compared to Attending MD/DO:
Novice (identifies/uses rules of thumb):
Follows specific rules for specific circumstances regardless of modifers or context. No personal ownership/responsibility except to the rule (i.e., EKG for chest pain no if's, and's or but's).
Advanced Beginner (connects rules to reality):
Decisions made by rule application but some allowance for related conditions. No personal ownership/responsibility (i.e., EKG for dyspnea since that might be cardiac).
Competent (plans approach/execution and appreciates consequences):
Applies organizing principles or "perspectives" instead of using rules based protocols. These perspectives allow for sorting information by relevance (triage). Has personal responsibility/ownership. (e.g., pt with CP may have modifying factors make EKG not necessary).
Proficient (uses evidence and streamlines routines):
"Holistic similarity recognition:" Intuitive assessment, uses decision-making tactics and rules to make plan. (i.e., "this is an MI, what are the criteria for TPA?").
Expert (anticipates and uses intuition):
Does what works based on whole pattern recognition for both assessment and plan. No conscious breakdown into discrete elements. When this does not work, breaks down problem into discrete elements of rules and decision trees.
2) Target attending level behaviors (Dreyfus proficient):
1. Medical Knowledge:
¶ Knows and applies the foundations of basic science and clinical and behavioral medicine appropriate to family practice.
¶ Demonstrates through an analytical approach to clinical situations, an understanding and application of clinical medicine to patient care.
2. Patient Care:
¶ Incorporates management of multiple interacting morbidities, prevention, up to date standard of care, prevention and controversy, and facilitates longitudinal care within the medical home.
3. Professionalism:
¶ Demonstrates aware of ethical “gray zones” and variations in culture; can facilitate patient’s moral development in issues of cultural diversity through modeling and education
4. Interpersonal & Communication Skills:
¶ Uses a variety of communication styles to facilitate patient understanding and behavior change
¶ Manages family conflict, disruptive behavior, potentially litigious situations
¶ Adjusts case presentation style and content based on patient complexity and context of the presentation
¶ Ensures communication with PCP and that longitudinal chart incorporates all aspects of care
5. Practice-Based Learning and Improvement:
¶ Uses the EMR and IT to educate patients and evaluate and enhance the quality of medical care
¶ Shows facility with EMR and uses IT to access medical information regarding management of patients
¶ Recognizes errors in patient care, analyzes own behavior, incorporates feedback and applies improvements to related situations on the future
¶ Is able to provide effective and thoughtful feedback to peers
¶ Is able to provide effective and thoughtful feedback to “superiors”
6. Systems-Based Practice:
¶ Partners with health care managers and providers to assess, coordinate and improve health care, and knows how these activities affect system performance
¶ Strives to affect public health and policy Works to create public health policy
7. Osteopathic Philosophy (for M.D.s AND D.O.s:
¶ Understands a variety of modalities for whole person care and consistently applies those and/or refers appropriately
8. Osteopathic Manipulative Medicine (for D.O.s only):
¶ Uses understanding of viscerosomatic reflexes and findings on structural exam to facilitate diagnosis & management of patients
¶ Actively incorporates a variety of both direct and indirect techniques to address needs in a variety of encounter types
3) Competency level (compared to peers):
□ Below Expectations □ Meeting Expectations □ Exceeding Expectations
Plan with Advancement Committee: FED (feedback, encouragement and direction) including successful methods and techniques unique to this resident (verbal, written, demonstration, self-directed):
1) Feedback (behavior specific, objective, useful):
2) Encouragement:
3) Direction: